Active NPI
Shannon Westmoreland Clark, M.A.P.
- Behavior Analyst
- Little Rock, AR
National Provider Identifier
1891087078
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 10-47AE
- Practice address
- 10515 W Markham St
Suite E3
Little Rock, AR 72205-2139 - Phone
- (501) 832-0592
- Fax
- (501) 225-3294
- NPI assigned
- May 6, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 10-47AE | AR | Primary |
Addresses
Primary practice location
10515 W Markham St
Suite E3
Little Rock, AR 72205-2139
Mailing address
10515 W Markham St
Suite E3
Little Rock, AR 72205-2139
Phone (501) 832-0592
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10-47AE | AR | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1304640000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1304640000000",
"number": "1891087078",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10515 W MARKHAM ST",
"address_2": "SUITE E3",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722052139",
"telephone_number": "501-832-0592",
"fax_number": "501-225-3294"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10515 W MARKHAM ST",
"address_2": "SUITE E3",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722052139",
"telephone_number": "501-832-0592",
"fax_number": "501-225-3294"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "SHANNON",
"middle_name": "WESTMORELAND",
"name_prefix": "Mr.",
"credential": "M.A.P.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-05-06",
"last_updated": "2011-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "AR",
"license": "10-47AE",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Little Rock, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.